‘Medische fouten zijn een epidemie’

Internal Bleeding, the Truth Behind America’s Terrifying Epidemic of Medical Mistakes is de titel van een nieuw boek dat vorige maand verscheen waarin twee wetenschappers van het UCSF Medical Center op zoek gaan naar de redenen achter het groeiend aantal slachtoffers van medische fouten. Alleen al in de VS sterven per jaar zo’n 100.000 mensen aan de gevolgen van verkeerd medisch handelen.

Volgens de schrijvers ligt het niet aan de individuele artsen of verplegers, maar door een gebrekkig systeem en een verkeerde instelling van de medische professie als geheel.

Q: Many people find it hard to believe that 100,000 Americans are killed by medical errors each year. Do you think this ghastly estimate is accurate?

A: It’s probably about right. It’s the best data we have, and those studies were good studies. For every argument that says the numbers were too high, there is a counterargument to say they are too low.

Q: If medical errors are that great a problem, shouldn’t we be purging the people who make them?

A: We have not done a very good job of weeding out (incompetence). … But most errors are being committed by good, caring people, most of them well- trained to do their very best.

[…]

Q: So the solution is to fix the system, rather than punish the people who make mistakes?

A: It’s closer to the truth than the paradigm that errors represent individual screw-ups by people who are either not smart enough, or not working hard enough. We have to recognize that human beings will make errors. It requires a new systems approach.

Q: It reminds me of the old IBM slogan: “The System is the Solution.”

A: We’re not building widgets. We’re not trying to be sure the trunk closes perfectly every time, with just the right sound. But most errors could be caught by a thoughtful implementation of systems that anticipate errors and catch them.

Q: You, and for that matter, many other medical quality experts, cite the airline industry as an example the health-care field should follow in terms of improving safety. Why?

A: The lesson from aviation is that they said, “We’re not going to fix this by getting the pilots to be more careful.” They focused on the error- prone things we all do. … Accidents are almost never caused by one thing. It’s like the stars all aligning in a nasty way.

Q: Don’t you point out in your book that doctors, compared to pilots, may have an arrogance or overconfidence problem?

A: There was a study where pilots and surgeons were asked if they would want their decisions questioned by junior team members in real time if they suspect you are doing something wrong. Ninety percent of the pilots said, “yes. ” Only 50 percent of the surgeons said “yes.”

Bron: SF Gate

Gezien in dit licht is het vreemd dat recent het medische establishment, naar aanleiding van de dood van Sylvia Millecam, zo tekeer ging tegen de alternatieve genezers. Doet de gevestigde geneeskunde het dan zo goed? Of zijn ze inderdaad te arrogant om de balk in hun eigen oog te zien?

Is het daarom dat ze naar makkelijke slachtoffers als rokers zoeken om hun superioriteit te kunnen bewijzen? Of hebben ze de junk science nodig om de cijfers rond hun eigen falen op andere gebieden te verdoezelen?